Abstract

Background and Objectives: pterygium is a common extraocular disease, seen in tropical countries like India. Pterygium is an elevated, triangular, fibrovascular encroachment of bulbar conjunctiva on to the cornea. A small pterygium usually gives rise to no symptoms. But, if large can be quite bothersome cosmetically, induce astigmatism or cause impair vision. But the most common symptoms are irritation, watering, foreign body sensation due to dry eye. Surgical removal of pterygium with Autoconjunctival graft or with 0.02% Mitomycin-C for 2minutesremains the mainstay of treatment. Hence this study is conducted to know the relation between dry eye and pterygium, and also to know the reliable test for dry eye in pterygium & post pterygium surgery.

Methods: The present prospective randomized clinical trial was conducted at Basaveshwar Teaching & General Hospital, Gulbarga, over a period of two years. In the study, 80 eyes of 80 patients were included after detailed preoperative evaluation. After informed written consent, they were randomized into two groups to receive either conjunctival autograft or Intraoperative application of 0.02% Mitomycin-C for 2 minutes, following excision of pterygium. Tear breakup time [BUT], schirmer’s test-1 and schirmer’s test-2 were done in all 80 eyes preoperatively and after 2months post-pterygium excision surgery. 80 cases completed the study.

Results and Observations: The majority of patients were in the age group 40-49 years(37.50%).Mean age of the patients was 44.133 years. 45 (56.25%) patients had bilateral pterygium and 35 cases were unilateral(43.75%). 76 cases(95%) were primary pterygium and 4(5%) cases were recurrent pterygium.51.9% of the patients with primary pterygium  had occupations involving predominantly outdoor activity.

Of 80 cases, 51 patients (63.75%) were positive with Schirmer’s test I, 49 patients(61.25%) with Schirmer’s test II and 52 patients(65%) with TBUT, preoperatively. 44 patient (55%) were positive with Schirmer’s test I, 41 patients (51.25%) with Schirmer’s test II, 14 patients(17.5%) with TBUT, postoperatively.

Conclusion: From the present study, we conclude that pterygium causes unstable tear film causing dry eye. Tear film abnormality improves after pterygium excision surgery with Autoconjunctival graft or with 0.02% Mitomycin-C for 2minutes. Both the methods were safe.

Further TBUT was more reliable test than schirmer’s test in assessing the correlation between dry eye in pterygium and post pterygium excision surgery.